a nutritional journey to optimal bone health

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Archive | December 2011

As I reeled under the news of my low bone density, I grappled with guilt: If only I’d drunk more milk. Now, I used to have some each day, and during my pregnancies I meticulously counted four glasses a day, without fail. Cheese and unsweetened live yogurt have always been favourite foods, too. Yet, I’d internalised the media message: weak bones = too little milk, so on news of my osteoporosis I concluded I just hadn’t done enough. My fault.

But then I discovered a confusing piece of news: countries with the highest dairy consumption also have the most osteoporosis! Yes, despite milk’s legendary calcium content, those who drink the most have the weakest bones. So what’s with that???

Our bodies are about 1-2% calcium, mostly stored in our bones and teeth. Milk contains lots of calcium, and we can absorb about 32% of the calcium from dairy products, which is fairly good. As it turns out, though, our bones need more than just calcium. For one, they must have magnesium; too little of this mineral alters the way the body metabolizes calcium, and the hormones that regulate calcium. But calcium and magnesium compete for the same absorption channels in the body, so too much of one will lead to a deficiency of the other; with our dairy-rich western diet, that loser is invariably magnesium, already in short supply. Magnesium deficiency will keep the body from using the calcium that shut it out in the first place!

Another major problem concerns the acid-base balance inside us. We’ve all heard of the problems of acid rain: if precipitation is too acidic – usually from industrial waste released into the air – when it hits the ground it leaches minerals out of the rock. Scientists have called this “osteoporosis of the lakes”, because it is so similar to a process in the body that can leach minerals out of our bones. In our bodies, this acid/base (pH) balance is affected by the foods we eat. I’ll explain more about this later, as it’s a very big topic. But in short, most fruits, vegetables, nuts, and seeds leave an alkaline residue in the body, while meat, grains, and dairy products acidify the body. In this delicate balance, the typical western diet leaves us very vulnerable.

So in response to my diagnosis, I have reduced my milk consumption, reduced grain intake, and increased magnesium sources, such as nuts.

Who ever convinced us to entrust a single food group with the health of our bones in the first place? I haven’t uncovered the definitive answer to that, but I can guess it’s someone who benefits from the dairy industry’s success. It certainly isn’t the consumers.

In my early reading, The Myth of Osteoporosis by Gillian Sanson served to calm me down. The author methodically debunks several key tenets of the medical approach to osteoporosis. For instance, less dense bone is not necessarily brittle bone. (Think of peanut brittle: dense but fragile.) And other factors than low density seem much more significant to the question of fracture risk. For example, risk of falling, regardless of bone density, is a better predictor of broken bones.

Dr. Alan Gaby, in Preventing and Reversing Osteoporosis, as well as in his mammoth work entitled Nutritional Medicine, outlines a very practical response to osteoporosis. That brings me to the gluten story.

The gluten story

Almost two years before my bone density test, a chance encounter with an alternative health practitioner convinced me to try eliminating gluten from my diet. While demonstrating a novel non-invasive testing method she diagnosed me with low levels of Vitamin A, Vitamin B6, Vitamin B12, and iron. Although I was aghast at her suggestion that I was malnourished (“But you don’t know me: I eat an excellent balanced diet!”), I set about researching symptoms of gluten intolerance, and found my family tree riddled with them, although never diagnosed as gluten issues: anemia, peripheral neuropathy, colon cancer, depression. The information was compelling enough that I made radical changes in my eating, and watched the following symptoms all disappear: daily headaches, eczema, insomnia, joint pain. I felt healthier than I had in decades, and I watched my nutrient levels rebuilding. When my daughter eliminated gluten, her depression and brain fog resolved within a week, as did her persistent bloating after meals. My sister’s “irritable bowel” was healed.

In those who are sensitive to gluten, ingesting a small amount causes severe inflammation of the small intestine in the area where several key nutrients are meant to be absorbed. This prevents their absorption, resulting in malnutrition. The effects of this can impact any system or organ of the body. The only treatment for gluten intolerance (or celiac disease, which is the best-known form) is strict adherence to a gluten free diet for life.

Because there is no pharmaceutical solution to this, the conventional medical profession has paid little attention to the growing problem, believed to affect around 1% of the population, although most are undiagnosed.

But now I learned something new and troubling from Dr. Alan Gaby’s work: Osteoporosis is commonly caused by gluten intolerance, and can even be the primary manifestation of celiac disease! So it’s quite likely that my bones never did reach the peak density they should have in my 20s, and the bone that did form has been leaching away silently for many years.

Enter the medical profession. They happily diagnose osteoporosis. They have a drug for that.

I was stunned. This wasn’t the news I was expecting. When my doctor’s office called me in for a non-urgent followup after my first ever bone mineral density test, I anticipated being told that the aging of my bones might lead one day to osteoporosis, and being urged to take a drug to prevent that.

“You have severe osteoporosis. A diagnosis of this begins at a T-score of -2.5 Your spine measures far worse than that – it’s -4! You’re at high risk of a spinal fracture. We have no choice but to prescribe bisphosphonates.”

She went on to warn me: “Make sure you don’t fall. You mustn’t do any activities that may cause you to fall. No more ice skating, no skiing, no climbing on ladders, no riding bicycles. Be careful. A fracture could happen at any time. Be very careful. Take lots of calcium.”

I left the office in a blurry fog of unreality, and stepped cautiously across the parking lot to my car, feeling like a piece of delicate crystal. How could I have felt so fit and healthy just a half hour ago, when my body really was critically frail?

As I tried to process the report, the doctor’s dark words hung over me, and I felt my confidence ebbing. Was it safe to lift a full laundry basket? To twist around to look in the back seat of the car? To bound up the stairs like I always had? My initial Google search just confirmed the worst: I have elderly bones in a 54-year-old body. No running, no jumping, no twisting for the rest of my life, or face cruel years of handicap and pain.

My first response

I cried. I fussed. I stayed home from the gym and wallowed in my mortality.

What about the prescription?

Then there was the drug. I already knew that taking bisphosphonates risked some serious side effects – atypical brittleness of the thigh bone, almost at its thickest point; and an untreatable necrosis of the jaw. And that a very high percentage of users suffered with digestive issues, joint pain, bone pain, and flu-like symptoms while on the drug. I did not want to ingest anything like that if there was an alternative.

As I looked into it further, I discovered that until around 1990 bisphosphonates were just industrial corrosion inhibitors. Then someone had the idea of having women take them internally to build bone density. The particular drug prescribed for me is called Actonel, and it was developed by Proctor and Gamble, the chemical company we’ve all heard of. The story of them getting it on the market includes a plot of intrigue and controversy, as the high level scientist whose name was used to publish the glowing research report complained that P & G had withheld the raw data even from him, only giving him access to the small subset that seemed to show benefits of the drug in bone density. He asked to have his name removed from the published paper.

It turns out that bisphosphonates work by killing off the osteoclasts in our bones. These are cells that function to break down old bone, effectively cleaning up the regular debris from wear and tear in our skeletal systems. Osteoporosis happens when these osteoclasts are too active, cleaning away old bone cells faster than new ones are built. The drug gives an initial increase to bone density, as no more bone is taken away.

The resorption work of osteoclasts is normally complemented by the work of osteoblasts. They serve to build new bone, repairing our frequent little micro-tears, and replacing elderly cells. Unfortunately, it seems that these osteoblasts eventually stop working in the absence of their clean-up partners. So after an initial increase in bone density while on bisphosphonates, the density levels off. Worse than that, repair of minor damage ceases, and old cells aren’t cleaned away. The bone that remains may be more dense than before, but evidence suggests it is also more brittle.

Was it true I had no choice?

It didn’t make sense to me that an industrial chemical taken internally, resulting in continuous pain and eventual bone failure, was a good solution. When it came right down to it, I thought I’d rather spend a cloistered life in a bubble but feeling healthy. Or face an early death from bone collapse after a life fully lived. I folded the prescription and hid it in the bottom of a drawer.

Wasn’t there another approach? Surely our bodies are created to heal, and optimum diets can provide what we need. What had gone wrong with my body that some cells were overperforming? What could I do to turn things around?

I began reading everything I could find on the subject, and that pointed to the reason I’m blogging: There is an astounding amount of information available on natural approaches to osteoporosis that have worked for real-life people! Since my diagnosis, my three sisters have followed up with their doctors – and ended up with the same label as mine: osteoporosis. Recognizing a genetic link, as our mother and her sister were also afflicted, I’m thinking ahead to the bones of our children as they age. Obviously, I’m not the only one urgently searching for answers, and it makes sense to me to consolidate what I’m learning and share it with others.